Journal article
Are gastric, jejunal, or both forms of enteral feeding gastroprotective during stress?
The Journal of surgical research, Vol.88(1), pp.1-7
2000
DOI: 10.1006/jsre.1999.5727
PMID: 10644458
Abstract
Background. Clinical data suggest enteral nutrition prevents stress ulceration and intragastric nutrients prevent restraint-induced gastric injury. The purpose of these studies was to determine if jejunal nutrients can protect without gastric contact and to determine if gastric pH, motility, or mucosal perfusion is affected.
Methods. In Experiment 1, 27 rats were restrained for 2 h at room temperature followed by 2 h in cold (4°C), with intragastric (IG) or intrajejunal (IJ) 2 ml/h infusions of saline or 25% glucose. Gastric lesions, pH, volumes, and glucose concentrations were measured postmortem. In Experiment 2, 23 rats had gastric strain gauges implanted >5 days prior to a 0.5 ml/h IG or IJ infusion during stress. In Experiment 3, 40 rats were anesthetized for laser Doppler measurements of gastric mucosal perfusion and arterial catheter monitoring of systemic hemodynamics. Rats received 0.5-ml boluses of concentrated glucose or saline IG or IJ, and were monitored for 60 min.
Results. (1) The 2 ml/h IJ and IG glucose infusions prevented gastric injury, but the elevated gastric glucose concentrations suggested equal gastric contact. (2) The 0.5 ml/h glucose IG and IJ infusions decreased gastric injury without reflux of the IJ glucose into the stomach and suppressed stress-induced hypercontractility, but not acidity. (3) Systemic perfusion pressures were unaffected by enteral glucose. IG glucose had little effect on gastric mucosal perfusion, while IJ glucose decreased gastric perfusion within 5 min.
Conclusions. These studies show that large volumes of enteral glucose prevent restraint injury but IJ glucose refluxes into the stomach. The gastroprotective effects of small, nonrefluxing volumes of IJ glucose are associated with suppression of stress-induced gastric hypercontractility, but not with suppressed acidity or enhanced perfusion.
Details
- Title: Subtitle
- Are gastric, jejunal, or both forms of enteral feeding gastroprotective during stress?
- Creators
- K. S EPHGRAVE - University of Iowa College of Medicine, Iowa City, Iowa 52242, United StatesD. L SCOTT - University of Iowa College of Medicine, Iowa City, Iowa 52242, United StatesA ONG - University of Iowa College of Medicine, Iowa City, Iowa 52242, United StatesJ. J CULLEN - University of Iowa College of Medicine, Iowa City, Iowa 52242, United StatesK. A BROADHURST - University of Iowa College of Medicine, Iowa City, Iowa 52242, United States
- Resource Type
- Journal article
- Publication Details
- The Journal of surgical research, Vol.88(1), pp.1-7
- Publisher
- Elsevier; New York, NY
- DOI
- 10.1006/jsre.1999.5727
- PMID
- 10644458
- ISSN
- 0022-4804
- eISSN
- 1095-8673
- Language
- English
- Date published
- 2000
- Academic Unit
- Surgery; Radiation Oncology; Internal Medicine
- Record Identifier
- 9984051711602771
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